Book Review
Pharmacological aspects of nursing care in Australia
Barry S Reiss, Mary Evans and Bonita E Broyles
ISBN: 978-0766805026; 1993; 976 pages; Thomas Nelson, Australia;
Ian L Blight
Intensive Care Unit, Royal Adelaide Hospital, SA
The authors appear to have set out to write a pharmacology book that is targeted for the nursing student. This text is much more than an exhaustive list of drugs, their uses, contra-indications and side effects as can be found in many pharmacology texts.
It is actually aimed at nurses and achieves the correct depth of knowledge and relevance needed for general nursing practice. The overall plan is well thought out. There are 12 major sections and subsequent chapters according to disease process and body system. Each chapter follows the same format beginning with a table of objectives to be achieved. When necessary this is followed by a concise refresher of anatomy and physiology for that system and an update of the disease process involved.
In a clear and easy to read style, the drugs are then discussed, making note of major side effects and safety aspects of administration. This is supplemented with a table listing doses, routes of administration and side effects. Reference is always made to the differences between paediatric and adult doses and the special needs of each group. Tables of key nursing implications accompany each group of drugs for easy reference.
The nursing process is applied to the disease and care of the patient receiving the medication. As well as covering all the normal aspects of drug administration it consistently incorporates aspects of health education, first aid principles, safety issues and legal requirements that nurses should follow. Goals for outcome of care are also discussed. Each chapter concludes with a case study and subsequent questions for discussion, suggested activities, a list of multiple choice questions and further recommended readings. Only in one chapter could I find answers for the questions asked. It would be an improvement if answers for all the multiple choice questions were included. There are many excellent chapters. I found the 'Principles and Methods of Drug Administration' to be very thorough. It provides a good learning base for nursing students to begin their nursing practice.
Another chapter of note is that on 'Toxicology and Envenomation', a subject not always seen in a nursing text. This covers aspects of poisoning caused by drugs, plants, creatures, and treatment needed including first aid measures. There are four appendices, firstly a Nomogram for body surface area estimation of adults and children.
Secondly a list of the principal Poison Information Centres in Australia and New Zealand. Then a table listing the uses and routes of administration for the various radiographic contrast media. Fourth is a table of common drug interactions that are thought to be of clinical significance, and the nature of the interaction. The appendices are followed by a glossary of some terminology that is used in the text. The book is completed by an index. I found the content to generally be quite accurate and current. I did however find a few minor omissions in areas of my own speciality. In 'Patients in Cardiac Emergencies and Shock' it is mentioned that 'if an intravenous line cannot be established, drugs may be given through an endotracheal tube' (p.537).
It is usually recommended that they be diluted and twice the normal dose given. Also the only drugs that are safely given by this route are lignocaine, atropine and adrenaline. In the same section it states 'sympathomimetic drugs may result in tissue necrosis'. It should also mention that, because of this, some sympathomimetics should ideally be administered via a central venous line. The index is quite accurate and I was able to find only a few minor omissions. Mannitol is referenced under diuretics and antihypertensitives (p.579) but not under osmotic diuretics used in glaucoma (p.492). Also the use of mannitol in the reduction of cerebral oedema post head injury is not mentioned.
Dantrolene sodium is discussed on pages 416-417 but this is not in the index. In summary I found this book had a sound basic format and it is written in a clear, easy to read style. The authors achieved their objective of providing a text that is aimed at the nursing student. I was impressed by the constant references to patient education, safety and clinical application to nursing care. I would highly recommend this text to the nursing student.
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